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This study supports the notion that an early return to school (RTS), results in faster recovery from concussion symptoms versus prolonged absences.
Source
Association Between Early Return to School Following Acute Concussion and Symptom Burden at 2 Weeks Postinjury. JAMA Netw Open. 2023 Jan 3;6(1):e2251839. doi: 10.1001/jamanetworkopen.2022.51839.
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Intra-articular lidocaine (IAL) is a safe alternative for the reduction of anterior shoulder dislocations and may have similar efficacy to intravenous (IV) sedation, with fewer adverse events and shorter ED length of stay.
Source
Intra-articular lidocaine versus intravenous sedation for closed reduction of acute anterior shoulder dislocation in the emergency department: a systematic review and meta-analysis. CJEM. 2022 Dec;24(8):809-819. doi: 10.1007/s43678-022-00368-z. Epub 2022 Oct 1.
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Electrocautery trephination of acrylic nail products attached to simulated digits was associated with a high likelihood of ignition (83/200; 41.5%). Based on this limited data, electrocautery trephination of acrylic nails should be avoided to reduce risk of further patient harm.
Source
Up in Flames: The Safety of Electrocautery Trephination of Subungual Hematomas with Acrylic Nails. West J Emerg Med. 2022 Feb 23;23(2):183-185. doi: 10.5811/westjem.2021.10.53567.
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Skeletal muscle relaxants (SMRs) + nonsteroidal anti-inflammatory drug (NSAIDs) do not improve outcomes any more than placebo + NSAIDs in the treatment of low back pain (LBP). Even when stratified by age, sex, history of LBP, and initial severity, SMRs still did not win against placebo.
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In this large registry study, SARS-CoV-2 infection in young competitive athletes carries a low prevalence of cardiac involvement (0.5-3%) and low risk of clinical events in short-term follow-up.
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Patients who received opioids in the ED for low back pain were significantly more likely to return to the ED within 30 days for the same complaint when compared to those who received only NSAIDs, acetaminophen, or a combination of the two.
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The prevalence of silent myocarditis among collegiate athletes, detected only on cardiac magnetic resonance imaging was 3%.
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In outpatients with acute sciatica, physical therapy had a statistically but not clinically significant effect on patient disability compared with usual care.
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This posterior ultrasound (US) approach to identify shoulder dislocation had 100% sensitivity and specificity for shoulder dislocation and was faster than x-ray by 43 minutes. However, the 92% sensitivity (with a lower 95% CI of 60%) for identifying non-Hill-Sachs/Bankart fracture makes me cautious about completely adopting POCUS until larger studies are done.
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NSAIDs are an effective treatment for low back pain, though the absolute reduction in pain and disability is small.
